Provider Demographics
NPI:1235134339
Name:CARSON, ERIK J (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:J
Last Name:CARSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:5301 E HURON RIVER DR
Practice Address - Street 2:STE C-139
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1051
Practice Address - Country:US
Practice Address - Phone:734-712-1000
Practice Address - Fax:734-712-3218
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2014-01-16
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Provider Licenses
StateLicense IDTaxonomies
MI066472207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4178123Medicaid
MIG96572Medicare UPIN